MEDICARE: SILENT SENIORS COMMUNITY CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant
2	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1407196819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILENT SENIORS COMMUNITY CARE LLC

Provider Business Mailing Address
First Line	:	13010 MORRIS RD
Second Line	:	BLDG 2
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-3873
Country	:	US
Telephone Number	:	678-942-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	13010 MORRIS RD
Second Line	:	BLDG 2
City	:	ALPHARETTA
State	:	GA
Zip	:	30004-3873
Country	:	US
Telephone Number	:	678-942-2000
Fax Number	:

Authorized Official
Title or Position	:	VP OF CLINICAL OPERATIONS
Name	:	LYNNE PADILLA
Credential	:	CPC
Telephone Number	:	505-228-1857

Provider Enumeration Date	:	02/21/2013
Last Update Date	:	02/21/2013

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